Skin and soft tissue infection suspiciously caused by <em>Klebsiella</em> <em>pneumoniae</em> in an aquaculture worker: A case report

Xie,Caipeng; Li,Na; Chen,Yan; Liang,Yongtao; Huang,Libing; Xie,Xiaoyang; Wang,Dongming; Wang,Haitao; Huang,Guanjun

doi:10.3892/mi.2024.158

Skin and soft tissue infection suspiciously caused by Klebsiella pneumoniae in an aquaculture worker: A case report

Authors:
- Caipeng Xie
- Na Li
- Yan Chen
- Yongtao Liang
- Libing Huang
- Xiaoyang Xie
- Dongming Wang
- Haitao Wang
- Guanjun Huang
View Affiliations

Affiliations: Department of Clinical Pharmacy, Central People's Hospital of Zhanjiang, Zhanjiang, Guangdong 524033, P.R. China, Department of Rheumatology and Immunology, Central People's Hospital of Zhanjiang, Zhanjiang, Guangdong 524033, P.R. China, Department of Hematology, Central People's Hospital of Zhanjiang, Zhanjiang, Guangdong 524033, P.R. China, Department of Emergency Medicine, Central People's Hospital of Zhanjiang, Zhanjiang, Guangdong 524033, P.R. China, Department of Clinical Laboratory, Central People's Hospital of Zhanjiang, Zhanjiang, Guangdong 524033, P.R. China
Published online on: April 23, 2024 https://doi.org/10.3892/mi.2024.158
Article Number: 34
Copyright : © Xie et al. This is an open access article distributed under the terms of Creative Commons Attribution License [CC BY 4.0].

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

Skin and soft tissue infections (SSTIs), which are mainly caused by Gram‑positive cocci existing on the skin surface, are more common than those caused by Gram‑negative bacteria; however, the role of Gram‑negative bacteria as emerging pathogens in SSTIs cannot to be ignored. Klebsiella pneumoniae is an opportunistic pathogenic bacterium that mainly inhabits the respiratory and intestinal tracts of humans and animals, as well as the environment, including aquaculture farms. This bacterium can cause multiple infections in humans and animals. The present study reports the case of a SSTI which was suspected to be caused by Klebsiella pneumoniae in a 74-year-old farmer with venous thrombosis. The patient had exposed his four bare limbs to the farmed shrimps and shrimp pond routinely. Pustule and skin ulcers were observed on both the legs of the patient. After receiving anti‑infection therapy, the SSTI was almost completely resolved on day 9 and the patient was then discharged.

View Figures

View References

1	Martin RM and Bachman MA: Colonization, infection, and the accessory genome of Klebsiella pneumoniae. Front Cell Infect Microbiol. 8(4)2018.PubMed/NCBI View Article : Google Scholar
2	Sivaraman GK, Rajan V, Vijayan A, Elangovan R, Prendiville A and Bachmann TT: Antibiotic resistance profiles and molecular characteristics of extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae isolated from shrimp aquaculture farms in Kerala, India. Front Microbiol. 12(622891)2021.PubMed/NCBI View Article : Google Scholar
3	Sivaraman GK, Sudha S, Muneeb KH, Shome B, Holmes M and Cole J: Molecular assessment of antimicrobial resistance and virulence in multi drug resistant ESBL-producing Escherichia coli and Klebsiella pneumoniae from food fishes, Assam, India. Microb Pathog. 149(104581)2020.PubMed/NCBI View Article : Google Scholar
4	Du F, Ma J, Gong H, Bista R, Zha P, Ren Y, Gao Y, Chen D, Ran X and Wang C: Microbial infection and antibiotic susceptibility of diabetic foot ulcer in China: Literature review. Front Endocrinol (Lausanne). 13(881659)2022.PubMed/NCBI View Article : Google Scholar
5	Hu T, Wang M, Chen W, Zhao J and Xiong J: The clinical characteristic and outcome of skin and soft tissue infection in immunosuppressive patients with nephrotic syndrome. Clin Exp Nephrol. 24:779–788. 2020.PubMed/NCBI View Article : Google Scholar
6	Murali S, Pillai AV and Ramachandran R: Efficacy of colistimethate sodium as local application in necrotising fasciitis. BMJ Case Rep. 12(e232354)2019.PubMed/NCBI View Article : Google Scholar
7	Ioannou P, Tsagkaraki E, Athanasaki A, Tsioutis C and Gikas A: Gram-negative bacteria as emerging pathogens affecting mortality in skin and soft tissue infections. Hippokratia. 22:23–28. 2018.PubMed/NCBI
8	Yang H, Wang WS, Tan Y, Zhang DJ, Wu JJ and Lei X: Investigation and analysis of the characteristics and drug sensitivity of bacteria in skin ulcer infections. Chin J Traumatol. 20:194–197. 2017.PubMed/NCBI View Article : Google Scholar
9	Silva JC, Constâncio V, Lima P, Nunes C, Silva E, Anacleto G and Fonseca M: Determinants of quality of life in patients with post-thrombotic syndrome. Ann Vasc Surg. 85:253–261. 2022.PubMed/NCBI View Article : Google Scholar
10	Murphy KD: Mechanical thrombectomy for DVT. Tech Vasc Interv Radiol. 7:79–85. 2004.PubMed/NCBI View Article : Google Scholar
11	Dias MKHM, Madusanka DMD, Han EJ, Kim HS, Jeon YJ, Jee Y, Kim KN, Lee K, Fernando IPS and Ahn G: Sargassum horneri (Turner) C. Agardh ethanol extract attenuates fine dust-induced inflammatory responses and impaired skin barrier functions in HaCaT keratinocytes. J Ethnopharmacol. 273(114003)2021.PubMed/NCBI View Article : Google Scholar
12	Gertner E and Lie JT: Systemic therapy with fibrinolytic agents and heparin for recalcitrant nonhealing cutaneous ulcer in the antiphospholipid syndrome. J Rheumatol. 21:2159–2161. 1994.PubMed/NCBI
13	Huys G, Bartie K, Cnockaert M, Oanh DT, Phuong NT, Somsiri T, Chinabut S, Yusoff FM, Shariff M, Giacomini M, et al: Biodiversity of chloramphenicol-resistant mesophilic heterotrophs from Southeast Asian aquaculture environments. Res Microbiol. 158:228–235. 2007.PubMed/NCBI View Article : Google Scholar
14	Abdallah Z, Staibano P and Zhang H: Fatal necrotizing fasciitis mediated by Escherichia coli after parotidectomy and neck dissection: A case report and review of the literature. Ear Nose Throat J. 3(1455613231214918)2023.PubMed/NCBI View Article : Google Scholar
15	Álvaro-Afonso FJ, García-Álvarez Y, Tardáguila-García A, García-Morales E, López-Moral M and Lázaro-Martínez JL: Bacterial diversity and antibiotic resistance in patients with diabetic foot osteomyelitis. Antibiotics (Basel). 12(212)2023.PubMed/NCBI View Article : Google Scholar
16	Yang Y, Chu WL and Feng G: Retrospective analysis of 2 997 inpatients with skin and soft tissue injuries. Zhonghua Shao Shang Za Zhi. 20:821–829. 2020.PubMed/NCBI View Article : Google Scholar : (In Chinese).
17	Gibson D, Chow O, Seth I, Siu AHY and Kwei J: Compartment syndrome as a novel complication of extended spectrum beta lactamase Escherichia coli necrotising soft tissue infection-A case report. Int J Surg Case Rep. 99(107574)2022.PubMed/NCBI View Article : Google Scholar
18	Cen H and Zhang L: Management of carbapenem-resistant Klebsiella pneumoniae infection in a patient with diabetic foot ulcer and necrotizing soft tissue infection, bacteremia and lung infection: A case report. Asian J Surg. 43:930–931. 2020.PubMed/NCBI View Article : Google Scholar
19	Carpenter RJ, Hartzell JD, Forsberg JA, Babel BS and Ganesan A: Pseudomonas putida war wound infection in a US Marine: A case report and review of the literature. J Infect. 56:234–240. 2008.PubMed/NCBI View Article : Google Scholar
20	Chen CH, Hsiu RH, Liu CE and Young TG: Pseudomonas putida bacteremia due to soft tissue infection contracted in a flooded area of central Taiwan: A case report. J Microbiol Immunol Infect. 38:293–295. 2005.PubMed/NCBI
21	Thomas BS, Okamoto K, Bankowski MJ and Seto TB: A lethal case of Pseudomonas putida Bacteremia due to soft tissue infection. Infect Dis Clin Pract (Baltim Md). 21:147–213. 2013.PubMed/NCBI View Article : Google Scholar
22	Xie ZY, Xiong Y, Sun J, Yang ZL, Yang HU and Yang H: Epidemiological characteristics and antimicrobial resistance of 9l strains of Pseudomonas putida. Chin J Infect Control. 16:1185–1188. 2017.
23	Shen Y, Lv Z, Yang L, Liu D, Ou Y, Xu C, Liu W, Yuan D, Hao Y, He J, et al: Integrated aquaculture contributes to the transfer of mcr-1 between animals and humans via the aquaculture supply chain. Environ Int. 130(104708)2019.PubMed/NCBI View Article : Google Scholar
24	Salgueiro V, Manageiro V, Bandarra NM, Reis L, Ferreira E and Caniça M: Bacterial diversity and antibiotic susceptibility of Sparus aurata from aquaculture. Microorganisms. 8(1343)2020.PubMed/NCBI View Article : Google Scholar
25	Das A, Behera BK, Acharya S, Paria P, Chakraborty HJ, Parida PK and Das BK: Genetic diversity and multiple antibiotic resistance index study of bacterial pathogen, Klebsiella pneumoniae strains isolated from diseased Indian major carps. Folia Microbiol (Praha). 64:875–887. 2019.PubMed/NCBI View Article : Google Scholar
26	Pham TTH, Rossi P, Dinh HDK, Pham NTA, Tran PA, Ho TTKM, Dinh QT and De Alencastro LF: Analysis of antibiotic multi-resistant bacteria and resistance genes in the effluent of an intensive shrimp farm (Long An, Vietnam). J Environ Manage. 214:149–156. 2018.PubMed/NCBI View Article : Google Scholar
27	Yang JT, Xiao DY, Zhang LJ, Chen HX, Zheng XR, Xu XL and Jiang HX: Antimicrobial resistome during the transition from an integrated to a monoculture aquaculture farm in Southern China. Sci Total Environ. 882(163511)2023.PubMed/NCBI View Article : Google Scholar
28	Kushawaha A, Mobarakai N, Cooper M, Rose K and Awasum M: Necrotising fasciitis with Vibrio vulnificus: A limb threatening dermatologic complication following exposure to marine life. BMJ Case Rep. 6(bcr11.2009.2478)2010.PubMed/NCBI View Article : Google Scholar